As a sidebar to my recent post wrapping up my Carb Nite experiment, I wanted to touch on a train of thought I had about blood glucose levels, low carb/ketogenic diets, and diabetes.

When I published my blog post discussing the results I was seeing with the carb nite meals and my own blood glucose results I received a few, almost shocked, comments about the high levels (200 - 300 mg/dL with one measurement over 300) that I saw following the high carb meals. Quoting one of the comments; "Those blood glucose peaks are at dangerous, diabetic levels."

It got me thinking: What is a "dangerous" blood glucose level? Does this mean I'm diabetic? I was fascinated by these questions.

Dangerous Blood Glucose Levels

First, the question of what is a dangerous level of blood glucose. Since I didn't know that answer, I did some research. I found that a truly dangerous level of hyperglycemia (high blood glucose level) occurs more in the range of 600 mg/dL, and is a condition known as "Hyperosmolar Hyperglycemic Nonketotic Syndrome" (HHNS). This most likely occurs with Type 2 diabetics, often when they have some other illness and are unable to rehydrate effectively, thereby raising the ratio of glucose in the blood. The body tries to reduce that level by increasing urination but that only exacerbates the situation. This condition can lead to seizures, heart attack, stroke and coma. I saw references to death rates with this condition as high as 40%, recognizing that these patients are typically very sick to begin with.

My glucose levels didn't spike nearly as high as this and I'm convinced that this couldn't happen simply through food -- however glycemic they are.

Chronic vs Acute

To understand the concept of "dangerous" I think it's important to separate chronic versus acute conditions. HHNS is an acute and very dangerous condition. It lasts for a short period of time (the patient would either get the condition corrected or would die), is very pronounced and it is an immediate threat.

Someone with pre-diabetes or diabetes has a dangerous condition because it is chronic. It's a condition that lasts over a long period of time, in this case many years. The damage is done because the blood glucose, and insulin levels, are elevated constantly and regularly, several times a day.

In the case of glucose and insulin spikes as a result of something like Carb Nite it is more what I would characterize as hormesis. Hormesis is a phenomenon where a brief exposure to something that would normally cause harm actually triggers a response from the body that is positive. There are numerous examples of this process. Two that come to mind are exercise and vaccines. When we exercise we cause damage to muscles. Our bodies respond by rebuilding the muscles and actually making them come back stronger in preparation for future challenges.

While it may not technically be considered hormesis, you can think of vaccinations in the same way. We expose our bodies to something that would normally be bad for us (a weakened virus for example.) This triggers a response by the body, which forms antibodies strengthening our immune system against a potential future exposure to that same virus.

The Carb Nite Solution is really a form of hormesis is some respect. If we agree that constant exposure to high levels of glucose and insulin is harmful over a long period of time, then brief spikes of such exposure (say one night a week) might create that same hormetic effect, stimulating the body to be better able to deal with it. (Improve insulin sensitivity.)

So while the glucose, and by extension insulin, spikes in this experiment were indeed very high, they were acute and not chronic. In fact, by my HgA1C numbers, on average, there is little damage being done by the glucose in my system (even after the experiment.)

If a Diabetic Doesn't Consume Carbohydrates . . .

Looping back to the title of this post, the old saying; "If a tree falls in a forest and nobody is around, does it make a sound?" I won't attempt to answer that, but by extension; "If a diabetic doesn't consume carbohydrates, are they diabetic?"

I have heard diabetes (at this point lets consider Type 2) described as a disease characterized by the inability to properly metabolize carbohydrates. When a type 2 diabetic switches to a very low carbohydrate diet, they typically see rapid, positive results. When you have an inability to handle carbohydrates, and you stop consuming them, then you should eliminate most of your problems.

But if the diabetic starts consuming carbohydrates they likely will quickly see issues with high blood sugar return, and over time the damage to their body will start to accumulate again.

I would guess that how quickly the problems return would depend on how damaged their metabolism was to begin with -- how weak is their pancreas (and the beta cells within) and how limited their ability to produce insulin.

In my case, I was pre-diabetic back when I started a low carb approach. With this experiment, the high glucose spikes reveal that my metabolism still has difficulty processing carbohydrates. (The damage of some 50+ years of abuse has taken its toll.) As long as I continue a low carb approach, I have none of the symptoms, nor blood glucose and A1c measures of pre-diabetes. So am I pre-diabetic as long as I'm on a low carbohydrate diet, or not. If a tree falls in a forest . . .

NOTE: In my earlier release of this post, I incorrectly reported my "After" HgA1c value as 5.7. It was actually 5.2. I've now corrected that error.

Back in November I began an experiment to see what effects a diet called "The Carb Nite Solution" would have on me. You can read about what I was trying to do here, and some of the progress in my experiment here and here.

The approach of Carb Nite® begins with a foundation of a very low carb diet, punctuated with evenings where a significant amount of carbs are consumed leading to a sharp insulin spike. This spike is said to trigger better insulin and leptin sensitivity, and the approach prescribes a carb night approximately every week.

With that background I intended to see if;

Carb Nite® would have any impact on my insulin sensitivity

The spike in glucose from the Carb Nites would be compensated by the increased insulin sensitivity the rest of the week, as measured by hemoglobin A1C

I felt any different

I observed any other health, weight, or other changes

I've completed my experiment. I did the test for about 3 months, with the first Carb Nite on November 13, and the last on February 11. In a sentence, I've concluded that, for me, the experiment likely did improve my insulin sensitivity over that period of time, and that this was not enough to compensate for the spike in glucose about once a week since my HgA1c increased somewhat, and that, for me, I did not like the impact on my feeling/health.

This is MY Experiment

Before diving into the details, I want to emphasize that this was an n=1 experiment, an experiment with only one subject, me. As such, part of these observations might have just been due to chance, and may only be the way this stuff affects me. These may not be the things that would happen to anyone else or it may not even be typical for any group of people. In other words, "your mileage may vary."

On the other had, n=1 experiments are valuable because sometimes what happens to the masses, doesn't happen to us individually. By testing on oneself, we know for sure what the changes we tried do to us as individuals.

Insulin Sensitivity

Before starting this experiment, I did my own "home brewed" glucose tolerance test. The idea of a glucose tolerance test is to measure blood glucose for a period of time after ingesting a fixed amount of glucose to measure how your body processes it. If you are insulin sensitive, blood glucose will spike up and drop back down to normal relatively quickly. If you are insulin resistant, blood glucose will spike even higher, and take longer to drop back to normal.

I did the test about a week before starting the first Carb Nite® and then did it again about a week after the last carb nite. My results are shown in the graph below.

From the graph, it's evident that in the "after" test, my blood glucose didn't spike quite as high, and came back down to baseline more quickly than in the "before" test. This would indicate that the experiment likely improved my insulin sensitivity somewhat. (Keeping mindful of my caution above though, I don't know if it's normal for my insulin sensitivity to vary from day to day this much so with a one time test like this, it is certainly not conclusive.)

This result is plausible however, so I believe it's probably true. When people, including me, first start practicing a low carb or particularly a ketogenic diet, it takes time for the body to adapt and begin to rebuild the enzymes and cellular structures needed to process the additional fat and adapt to using fat and ketones for fuel. It certainly makes sense that after about four years of using next to no glucose for fuel, my body would not be as good at processing it. By forcing my body to process a spike of carbohydrates periodically, as in this experiment, it would stand to reason that it would get better at it after 3 months.

HgA1c

If my insulin sensitivity is improved with Carb Nite, does that mean I'm healthier? In an attempt to assess that, I also did a Hemoglobin A1C test before and after as well. HgA1c is a measure of "glycated hemoglobin" in the blood. Hemoglobin is a molecule in red blood cells that transports oxygen. Glucose in the blood reacts with hemoglobin causing the hemoglobin to become glycated. The more glucose in the blood over a period of time, the more glycated hemoglobin is present. When blood cells are formed the hemoglobin isn't glycated. Over time it becomes more glycated depending on how much it is exposed to glucose in the blood. Blood cells have a lifespan of about 3 months so at any given time you should have some fresh blood cells and hemoglobin and some old blood cells and hemoglobin. HgA1c is a measure of the concentration of glycated hemoglobin and thus is a good measure of the average blood glucose levels over a period of about 3 months. It is also more or less a direct measure of the effect that glucose has on the tissues and systems in your body.

HgA1c is measured as a percentage which can be roughly correlated with an average blood glucose level over that 3 month period. Typically "normal" is interpreted as around 5% which is estimated to correspond to an average blood glucose of ~97 mg/dL"

My "before" test of A1C was 4.9%. My test after the experiment was 5.2%, a slight increase. This tells me that in this experiment, for me, the weekly spikes in glucose may have been large enough to affect my body in a negative way -- enough that the insulin sensitivity benefit couldn't compensate.

Weight

Weight is one of the least accurate measures related to health and yet it's the one we all seem to look at. I didn't make a significant attempt to track my weight throughout this experiment but I did take a look at before and after. It looks like my weight went up about a pound and a half. The problem with weight though is that you probably need about a five pound difference to be significant at all.

I do also use a body fat measuring scale, and my body fat percentage went up about 1/2%, which again, is very much within the range of error since this measure is very sensitive to other factors such as level of hydration.

Feeling

One of the most significant things I detected throughout this experiment was my general perception of how I felt. As the experiment progressed I just didn't feel as good. I didn't seem to have the usual energy that I have had since I switched to a low carb approach. I also started to get heartburn more regularly. Not just on the days I consumed carbs, but throughout the whole week. Prior to this experiment, I literally didn't have heartburn for almost 4 years since adopting low carb, and it completely went away within a couple weeks after ending the experiment. Finally, despite no measureable change in weight, I have felt like I have gained weight, particularly around the waist. It's possible some fat redistributed to around the waist (not a good thing) or I'm feeling some bloating, or it's just psychological.

Inflammation

Another observation I made towards the end of this experiment relates to a potential increase in systemic inflammation. Two health issues I dealt with over the course of this experiment were a cold that I had trouble getting rid of, and a bout of plantar fasciitis in my left heal.

I have had maybe two colds since I originally switched to a low carb approach but then I got another one while doing this experiment. The other two colds were over within a couple days and were mild. The one I got while doing this experiment I just couldn't seem to get rid of. While I believe the actual infection was gone within about a week, I had sinus pain, and significant congestion for over a month.

The issue with my heal is something I have had on and off for most of my adult life. Once I started wearing proper shoes (I found that a brand called San Antonio Shoes (SAS) almost completely cured the issue.) Even when It cropped up again after moving to a house with a slab foundation (with floors that don't have much flex) I could still take care of the issue with proper stretching exercises and utilizing the proper shoes. Since starting this experiment however, this has gotten much worse, enough that it was painful all day, difficult to walk, and forced me to visit a doctor who confirmed the plantar fasciitis diagnosis. While his modified exercises and topical anti-inflammatory helped, it hasn't gone away. I'll have to see if it continues to get better now that I've discontinued the carb nite experiment, but it has started to improve.

Conclusions

As with any n=1 experiment, it's impossible to make hard and fast conclusions for a trial like this, particularly any that would apply to anyone but myself. For me however;

I believe that this approach did improve my insulin sensitivity.

I believe that my metabolism and health was negatively impacted by the approach and that this was likely due to my particular sensitivity to carbohydrates. (I believe I would probably be diabetic, if not for practicing a very low carb approach.)

This approach isn't right for me (although I do recognize that Carb Nite isn't necessarily intended for continuous practice.)

It might still be good for me and certainly would do no harm to do a high carb day (probably with more "healthy" and whole foods and less sugar) on occasion. Perhaps just a few times per year.

I feel much better and my energy has returned now that I'm back on a very low carb/ketogenic approach.

I recognize that since this is a one time, n=1 experiment, a lot of the observations could be based on random variation and in fact, the cold and the plantar fasciitis could actually have led to the increase in HgA1c instead of the other way around. With a single test like this, there's really no conclusive way to tell, but I suspect that it's the sugar spikes that led to the inflammation instead of the converse.

I'm now about a month into my next experiment which i'll describe in a future blog post. You can get a bit of a hint about it by looking at my book list on the home page (or the link reproduced here) where I list all the related books I've been reading. (The most recent at the top of the list.) If you'd like to purchase any of those books, please use the links provided which take you to the amazon.com page for the book. If you buy a book, or anything else on Amazon, from one of those links, it helps keep this blog going.

I've now done the "Carb Nite" 6 times, and I have some interesting effects to report. I've set out to do this for at least 3 months and then assess changes in my insulin sensitivity (as measured by my do-it-yourself glucose tolerance test) and average blood glucose (as measured by a home A1C test.) I've reported on my baseline measurements for these tests in the first post on this experiment. I chose 3 months as a target since the A1C is representative of an average blood glucose level over that period of time.

Observations

While it's too early to do follow up measurements to see the effects, I've made a few observations so far in this experiment.

Meals

I've generally aimed at a "standard american diet" (SAD) approach with a high level of carbohydrates and low fat (<30% of calories). I have not made any strong attempt to focus on "quality" of food in this experiment since this is aimed at changing macronutrient ratios and see the metabolic effects. While I haven't necessarily intentionally avoided quality foods, I've just found that it's a little more difficult to do while following the "SAD" for only a day a week.

Since i consume most of these meals during a regular work day, they've mostly been at area restaurants that are near work. They've included Noodles & Co. as mentioned in my last post, Amerigo (Italian restaurant), a local Mexican restaurant, and Panda Express (a fast-food Chinese restaurant.) I also managed to time my "carb nites" so that I would have one on Thanksgiving. (Hey, why not have some stuffing, mashed potatoes, fresh rolls, and pumpkin pie!)

Blood Glucose Impact

I've tracked the impact on my blood glucose for most the carb nites I've tried. I've found that the curve is very similar to the first time I tried it. I continue to see the high peak, lasting over 3 hours. I've included a composite graph of all the blood glucose tests I've done over the carb nites.

Bloating

I've noticed that on the days when I would do the high carb meals I definitely felt over-full and bloated. I generally don't intend to overeat, but it's possible that I would be consuming more, either because I've tried to eat a lot of carbs, or because the carbs and the ensuing (intentional in this case) spike on insulin were driving overeating. In any event, I have definitely noticed a feeling of over-fullness after eating on these days.

Heartburn

I've noticed a return of some heartburn that I used to experience frequently before switching to a very low carbohydrate diet. Fortunately, I typically only notice it on the day I do the high carb eating, and I've not felt the need to take anything for it.

Muscle Cramps

Perhaps the most pronounced effect I experience, one that the book predicts, is muscle cramping, particularly in my toes. This is probably the most notable observation that I made which confirm one aspect of the Carb Nite theory. Muscles (and the liver) store energy in the form of glycogen. As mentioned in other posts, humans can store about 2,000 calories worth of glycogen. When practicing a very low carb dietary approach, a significant portion (perhaps half) of that glycogen is depleted since the body doesn't need as much. The consumption of carbohydrates on "carb nite" triggers the body to store what it doesn't immediately need in the form of replenishing that glycogen. When glycogen in stored, each molecule of it is stored with 4 molecules of water. This means that this glycogen replenishment cause dehydration.

I was aware of this effect going in and have tried to stay hydrated, but found that these cramps occur surprisingly quickly. As I've done more carb nites, I've started hydrating sooner and have reduced the muscle cramps.

Normally I don't get muscle cramps in my toes. When I have at other times, usually due to some other electrolyte imbalance, I get cramping in my calf muscles. Why the glycogen replenishment would instead cause it in the toes is interesting. The only explanation I can propose is that since I'm intentionally trying to stay hydrating, and the glycogen replenishment seems to happen quite quickly, the toes are at the extremity and it's taking longer for the water to distribute out to them.

Sleep

A reported benefit of this approach is that the consumption of carbs, especially in the evening, causes an increase in production of serotonin. Serotonin is the hormone that helps you feel good and helps to contribute to good sleep. I can definitely say that I've noticed this effect. At bedtime, when I'm doing the carb nite, I find that I'm very tired and ready to sleep. Much more so than when I'm not.

Another effect that the author reports is the feeling of increased body heat. This is supposed to be due to the excess carbs having to be burned, raising metabolism and thus body heat. I have not really observed this phenomenon.

Conclusion

Overall, the experiment is going well. I have been able to confirm some of the claims of the book but not others. The important effect that I'm looking for though, a positive effect on metabolic measures, I've not yet been able to assess. I'll do that after I've completed at least 3 months of the test. It is fun to have some of the "forbidden foods" from my normal, very low carb diet, but it's not something I would continue to do just for that reason. I don't really miss these foods and enjoy the high fat, low carb, whole foods that I normally eat.

From a health and weight standpoint, I've seen no benefits. In fact I "feel" like I'm less in-shape than before and that I've probably gained fat (although I've not measured any significant change so far.)

I tried my first "Carb Nite" a few weeks ago and it was an interesting and educational experience, but with no major surprises or changes. (See my post introducing this experiment.) First of all, my "Carb Nites" are really "Carb Afternoons." I am typically an early riser, usually waking up at around 4 in the morning. So I'm typically in bed by 8 at night. So to get a good 6-8 hours of carb binging in, I need to start around lunch time.

For my first attempt at this I went to lunch at Noodles & Co. If you aren't familiar with them, they are a fast food chain that specializes in pasta dishes of various cuisines, such as Italian, Asian, and American style dishes. Before I started eating low carb, I used to like to eat here. Even though they are a fast food restaurant, they are somewhat higher quality by making their dishes fresh to order and yet are reasonably priced.

I found it interesting to have to think of and select a high carb, low fat meal after thinking just the opposite for the past 3-1/2 years. It reminded me of the strange experience years ago when I was adapting from the SAD (Standard American Diet) to low carb, high fat eating. I experienced that same cognitive dissonance now when thinking about finding a low fat, high carb meal. I knew there was a rational reason to eat that type of meal but it felt wrong since I was very much not used to it.

Getting home late from work, I decided to just pick up a snack, and grabbed a bag of Chex Mix as the first low fat, high carb, (and yes, low quality) snack I found. At home, someone had given my wife a gift of some "boutique" cookies. Normally I would stay away from these but this was a great opportunity to take advantage of "Carb Nite" so I had a couple. The macronutrient totals for this "carb nite" was: Fat: 42 gms (28%), Protein: 47 gms (14%), Carbohydrate: 188 gms (57%), Fiber: 11 gms.

I tracked my blood sugar fairly closely through lunch and then a few hours after to see the effect of the meal. I know from experience that my typical low carb, high fat meal will result in little to no increase in blood sugar -- usually not over 100 and never over 130. The graph below shows the result with a peak of around 210 at about 2 hours after the meal. Blood sugar didn't return to normal until at least 4 hours after the the meal.

What I find interesting is a comparison between this graph and the graph that I did for the little glucose tolerance I did and reported on in my last post. I put those to the same scale in the graph below.

Even though in the glucose tolerance test I consumed only 30 gms. of carbohydrate, and in the lunch on "carb nite" I consumed about 76 gms., the carbs were different. First of all, the meal was consumed as a meal. There was fiber and protein, etc. that slow the digestive process, while the test was with pure glucose. The pure glucose gets absorbed into the bloodstream quickly while the meal gets absorbed more slowly. Thus the peak in blood sugar is "spread out" so it's not quite as high and takes longer to return to normal. In addition, all of the pure glucose goes to make blood glucose levels increase. Even pure sugar in the meal does not. Table sugar (sucrose) is about 1/2 glucose and 1/2 fructose. Fructose doesn't significantly raise blood sugar and is processed differently by the liver. (Fructose is the considered more damaging since it mostly gets converted to fat by the liver and most of that fat is deposited in the liver contributing to insulin resistance.)

I've been continuing this experiment by doing a "carb nite" every 5-7 days and will report on that in coming posts.

There are two themes that run through my mind with nearly all of the reading I've done on nutrition and health the last few years. One is that the most important thing anybody can change in their nutrition to get healthier is to abandon highly processed, "junk" food and eat real food -- as close to what we evolved to eat as possible. The other, and the one that I've been seeing more often recently, is the idea that there are different, similarly beneficial and successful diets, and that one diet might not be the best for all. I've also been observing that a change to one's diet (while staying somewhat within the parameters of "real food") might be highly beneficial.

An intriguing discussion of the concept of different, beneficial diets is an article entitled "In Defense of Low Fat" This is a fascinating, and very long article (I actually extracted it and converted it to read on my Kindle) that I'll cover in an upcoming post here. It's written by Denise Minger who also is the author of "Death by Food Pyramid."

But the topic today is from a book by John Keifer called the "Carb Nite Solution." (You can find the paperback version at this link. You can also find information on a pdf version at carbnite.com). It's about an approach to diet that he developed to help control his own weight and health, and based on extensive research of the literature that he did.

The Carb Nite Concept in Brief

The concept of the Carb Nite Solution® is that a very low carb diet is the best for fat loss, except that when practicing it over a long time, levels of cortisol (the stress hormone) increase and levels of leptin (the hormone that signals sufficient fat reserves in the body) decrease. By introducing a period of high carbohydrate consumption (about 8 hours) approximately once a week, the theory is that cortisol levels will be moderated and leptin levels will increase.

The other part of this theory is that when you practice a very low carb diet long enough, your body stops making enzymes that convert carbohydrates to fat. Since you generally don't have an excess, it makes sense that your system for that conversion will be down-regulated. Because of this, the claim is that when consuming the high levels of carbs on carb nite, your body won't be able to convert the excess to fat. Instead the carbs will go to reload glycogen stores in the muscles and liver, and the excess will have to be burned off. This results in an increase in metabolism to burn off the excess fuel.

This is somewhat like the adaptation when one starts a low carb diet. The enzymes needed to burn fat have been down-regulated and take a while to get built back up. This is why it takes a while to adapt to a very low carb diet.

I find this approach intuitive. It seems to me that staying on any one dietary approach, in an environment where we can obtain any kind of food at whatever quantities we want (as opposed to the environment in which we evolved -- one of periods of abundance and periods of scarcity) that our bodies will adapt. It seems that our bodies have evolved to be as efficient as possible with whatever is available, in order to prepare for the next period of scarcity. The availability might be an abundance of meat and thus protein and fat, or an abundance of vegetables, legumes, and fruits and therefor protein and carbohydrates. Thus, we would hormonally adapt to this monotonous diet and use that food very efficiently. By disrupting that pattern with periodic "shocks" of high carbohydrate consumption and the resulting insulin spike, we might be able to trigger fat burning and keep our metabolism raised, and be better able to handle the abundance of foods we have today.

In general, there's not necessarily an emphasis on quality of food during these "carb nites." In other words, there would be a tendency to bring "junk food" back in the diet, if only for part of one day a week. There seems to be an angle to this diet that the carb nite is a "reward" for all the suffering from what he calls the "severe carbohydrate restrictions" of the rest of the week. While I currently practice a very low carb diet, I don't see that this as a "severe restiction." Different from what the typical person today does certainly, but by no means "severe." I also don't feel the need to have a "reward" periodically. I enjoy eating foods in a very low carb, high fat, mostly real foods diet.

How I Will Approach This Experiment

A big question as I look to test this approach is how "junky" do I want to make my diet during this experiment? Do I want to include wheat (bread, pasta, etc.)? I think I will try this, at least for some weeks just to see how I feel. Possibly try a few weeks with wheat products and a few without to see if I can see a difference. Also, since there's an emphasis on spiking insulin, and a view of carb nite being a "treat," sugary products (cookies, cakes, etc.) are suggested. I probably will experiment with this as well, as much as anything to just make sure I'm getting enough of a blood sugar and insulin spike.

Since I've been on a very low carb diet for nearly four years, I shouldn't have to do anything special for the 9-day "reorientation" period that is prescribed to start the diet. Instead, I've spent the past few days monitoring myself, particularly with respect glucose levels, to get a decent idea of the baseline I'm starting with. In doing this, I've been able to recalibrate my diet a bit. I've noticed, in some cases, meals I hadn't paid as much attention to had more carbs and spiked my blood sugar more than I thought. (For example, meals that are otherwise low in carbs, but contain breaded dishes, contain more carbs and spike my insulin more than I thought, and I will have to make sure I stay away from these.

How I Will Assess the Results of My Experiment

The primary responses I want measure are metabolic. Do I improve my insulin sensitivity? Positive responses would include a lower fasting glucose reading, particularly first thing in the morning. I experience something called the "dawn effect" which is a natural spike in cortisol in the morning creating a spike in glucose. Despite the time I've been on a very low carb diet, and having a good A1C reading, I still see morning glucose readings in the 100 range. Daytime fasting readings, 3-4 hours after eating typically are in the low 90s.

I will also be checking my hemoglobin A1C. I've done the "before" test a few days ago and it was 4.9 -- a good reading. I will test it after trying the carb nite approach for at least 3 months. (Since the A1C test is reflective of long term glucose control.) I'm curious whether the reported benefits of the approach will compensate for the big spikes in blood sugar cause by gorging on carbs once a week.

I've also done a "before" assessment of glucose tolerance. I've done this test on myself by formulating my own Oral Glucose Tolerance Test (OGTT). [[I CAUTION MY READERS NOT TO FOLLOW WHAT I'M DESCRIBING HERE ABOUT THIS TEST UNLESS YOU REALLY KNOW WHAT YOU ARE DOING AND/OR HAVE MEDICAL SUPERVISION. THIS IS PARTICULARLY TRUE IF YOU ARE OR MIGHT BE DIABETIC OR EVEN PRE-DIABETIC.]] I started with a baseline glucose reading and then consumed 30 gms. of glucose in the form of two "glucose shots." This is less than half of what a medical OGTT would use, but I felt it was enough to spike glucose and assess my body's response. It's also in the range of a typical high carb meal (without any fat or fiber that would mitigate the glucose spike) so I felt it was safe for me. I then tested my blood glucose at about 30 minutes, 60 minutes, 120 minutes, and 150 minutes. The results are shown below. I think the spike was good enough to give me a baseline for comparison after I've done the carb nite experiment for awhile. If my insulin sensitivity has improved I should see less of a spike and a quicker recovery to a baseline reading.

In addition I have a baseline weight and body fat measure that I'll be able to compare to after doing the experiment for awhile. While weight is not necessarily a direct objective of my experiment, it is a primary target (actually fat loss) of the carb nite diet approach.

Finally, I will see whether I observe the "heat" response the night of the carb nite that is caused by the excess carbs that can't be converted to fat and must be burned. In addition, the serotonin spike and exceptionally good sleep that is claimed on carb nite. I'll also assess my overall feelings and changes that I perceive.

As this experiment progresses, I'll update you on my progress so stay tuned.

® "Carb Nite" is a registered trademark of John M. Kiefer and I have no affiliation with him.

One aspect of eating a very low carb diet is that it is much easier to skip meals. The intense hunger that demands to be fed, caused by low blood sugar and a brain that is totally dependent on that sugar, is no longer present. The brain is just fine, in some sense better off, fueled by ketones, the fuel derived from fat stores and manufactured by the body. For the small amount of glucose that your body needs, it can be manufactured from byproducts of the stored fat that's being burned, as well as from the protein in lean tissue. When I skip meals, I do still feel "empty" around the time I normally would eat, mostly out of habit more than anything else, but this passes quickly, and is usually replaced by a feeling of increased energy.

Since I've started this approach to eating, I've found myself naturally missing meals or even fasting for up to 20 - 30 hours. I find these fasts to be quite easy and actually enjoy the feeling of energy and mental focus they provide, likely due to the increased level of ketones in the blood.

Some have extended these fasts much longer. For example, Jimmy Moore, of "Livin' La Vida Low Carb" fame, has done a couple much longer fasts, and tracked the results with a great amount of detail. You can read about the 3 day fast he initially did, and the 18 day fast he just recently completed. (He hasn't blogged about that fast yet so the link takes you to one of the periscope videos that he did about it.)

My October-Fast

Last month I decided to try a more extended fast than I've done previously to see how it would go. There are a lot of reasons to do a fast. When people ask "why would you want to fast?" these are the things I think about.

Not consuming any protein or other nutrients used to build and maintain cells, forces the body to use other sources in order to continue the normal process of rebuilding tissue. One way it does this, is to trigger a process called autophagy. This is a process that triggers damaged cells to be torn down, releasing the material of the cell to be used to rebuild other parts of the body.

There is strong evidence that periodic extended fasting can help stop cancer cells that may be hiding in the body and could later develop into full-blown tumors. This is in part based on the theory presented by Dr. Thomas Seyfried, and based on research he and others have done as well as a theory that was first proposed in 1924 by Otto Warburg. (If you really want to study this theory in significant technical detail you can read Dr. Seyfried's book; Cancer as a Metabolic Disease. Note that this is a sponsored link.) Put simply, the Warburg Hypothesis says that primarily, cancer starts with the failure of the mitochondria in cells such that they can only inefficiently process glucose for fuel and not fats. This makes them highly dependent on glucose (as well as being susceptible to rampant mutation since there's not sufficient energy to maintain the cell's nucleus.) Therefore, a fast is a good way to kill off any latent, damaged, precancerous cells.

Fasting is believed to increase insulin sensitivity. This is more or less the opposite of metabolic syndrome which is characterized by insulin resistance. An advanced outcome of metabolic syndrome is type 2 diabetes. Dr. Jason Fung is a strong proponent of extended fasting as an effective treatment for type 2 diabetes, going so far as to assert that type 2 diabetes is completely curable through fasting. I'm beginning to believe that even a good dietary approach like very low carb, consistently practiced over a long period of time, can lead to increased insulin resistance and lower metabolism. Thus, fasting might be a good way to make a change to the diet to trigger positive results. (I'm seeing a number of different approaches to changing the diet all claiming to improve insulin sensitivity through changing the diet. I'm working to understand it better and might have a post in the future about it.)

It is good to know that I can do it. Beyond just the simple challenge to see what happens, its good to know that if I ever needed to, I could easily go without eating for an extended period of time. I would know what the effects are and what it feels like and I would know what things I would have to try to do to prevent problems (like staying hydrated.) So if the Zombie Apocalypse happens, I'll be prepared!

I got a device called a "Ketonix" which is basically a breathalyzer that can monitor the presence of ketones in the breath. This a simpler and ultimately cheaper means to estimate the level of ketones in the blood. The other way is to use expensive test strips. In order to use this device though, it really needs to be calibrated and it's likely that calibration is different for everybody. This fast then was a way to get a wide range of blood ketones in myself, measure them with the ketonix and test strips, and develop my own calibration curve. (I don't believe that everyone needs to constantly test their ketones to successfully follow these nutritional approaches. I do this because I have an intellectual curiosity and like to measure and study.)

How I did the fast

For this fast, it was not quite a "water fast" in which one consumes only water and no food or other nourishment. Instead, I did continue to drink coffee with a little heavy cream and "Sweet Leaf" brand stevia sweeter. As much as anything, I did that simply because I like coffee, and it added negligible nutrients to my fast. Heavy cream is almost all fat and very little protein so it should not negate any of the beneficial aspects of the fast.

The last substantial food I consumed, the morning I started the fast, was a cup of coffee with 2 T each of MCT oil and grass feb butter dissolved in it, typically called "bulletproof coffee." This drink triggers the production of ketones, which is one of the key intents of the fast, so I wanted to jump-start the process.

One of the side effects of fasting is dehydration, so I made sure I drank plenty of water, in addition to the coffee, and supplemented with potassium, magnesium, and consuming several pinches of sea salt while drinking water a couple times a day.

How I Felt

Overall, I felt fine throughout the fast. I felt like I was keeping hydrated enough because I didn't experience any of the downsides of that (headache, fatigue, etc.) I will note that the night after the fast I did experience a leg cramp. Leg cramps can typically be caused by loss of electrolytes or dehydration so I may have gotten a little depleted in that regard.

I periodically felt hungry, but this passed quickly, and I never felt as if I was weak or shaky as from low blood sugar even though it dropped to a low if 59 mg/dL during the fast. While I always felt like I had enough energy, and that I could do anything I needed to do, I didn't feel like I had any great surge of energy like I do with a 20 hour fast.

In the last 1/2 day or so I really felt like I wanted to eat. I seemed to crave food. In all this I didn't feel like I had to eat though, I just thought like I wanted to. In my mind I had planned to go for 3 days. I think this craving was driven mostly by the knowledge that I did plan to eat soon and I was therefor looking forward to it. The only way to really know, would be to extend the fast farther and see how I feel.

Ending the fast, I knew that I wanted to take it easy and not eat a large meal. In shorter fasts I've done, I learned that my system doesn't like to eat a large meal right away. I ended this fast with some macademia nuts, a small piece of aged gouda cheese, a scrambled egg cooked in a little butter, and glass of kombucha, waiting a little while between each to make sure my system was handling them well. An interesting observation is that the nuts and cheese tasted good, but when I tasted the scrambled egg it somehow tasted like the best thing I had ever eaten. It was an interesting and unexpected experience. It seemed as if my body was definitely missing the formidable nutrients that are in eggs and very much appreciated them.

Tracking (Warning - This is the "sciencey" section)

To track this fast, I regularly measured blood glucose, blood ketones, and breath ketones using the ketonix. I've inserted graphs of each of these variables below, showing the effect the fast had.

This graph shows my blood glucose measurements over the three days of the fast. The first reading was around noon of the first day, after the fast had begun. The last reading was one hour after having a small meal to end the fast. My blood glucose dropped to a low of 59 mg/dL before ending the fast.

This graphs shows the blood ketone measurements I made throughout the 3 day fast and then for a couple days after the fast. There is a steady rise in ketones from my typical level on my low carb diet of around .5 mmol/L. My ketones got as high as 3.7 mmol/L before ending the fast.

I was able to calculate a fairly good correlation between the Ketonix breath ketone readings and blood ketones over the course of the fast. I only used readings during the fast (as ketones were increasing) rather than after the fast (as ketones were decreasing) because of what I observed below.

By using the correlation I developed from the data during the fast, I was able to make the graph above that shows an equivalent blood ketone level as predicted by the Ketonix. This graph can be compared to the graph of measured blood ketones. After the end of the fast, the blood ketones drop quickly, returning to normal within 2 days. The breath ketones took a full day longer to drop to normal.

This can be understood by knowing what the blood ketone strips measure (beta-hydroxybutyrate) and what the Ketonix measures (acetone.) From this fast it became clear that acetone stays present longer, after the beta-hydroxybutyrate is depleted.

Summing it up

Overall this was a good experiment. I was able to calibrate my breath ketone measurements, completed a 3 day fast with no ill effects and feeling fairly good, and I got some interesting data. I expect that I'll do this again, probably once or twice a year, and may try a longer one to see what happens. Before that though, I plan to do a different experiment. This is with a diet approach called "The Carb Nite Solution." This is an approach I've known about for a couple years and have been very interested in, but have yet to try. A number of things I've been curious about have led me back to thinking about that approach and I plan on testing it myself to see what happens.

I am not, by any stretch of the imagination, an athlete. I have however been active enough to have participated, and continue to participate, in some endurance sports, particularly endurance cycling. I'm not a runner. The thing is, I've participated in and seen enough of these events to see how most people are constantly in search of carbs to keep themselves fueled along the way. Many still argue that "carb loading" before an event can optimize your performance by increasing the amount of glycogen stored in the body that can later be used as energy. See this and this.

The thing that the concept of carb loading misses is that a typical marathon runner can only store about 1,600 calories in the muscles and about 400 in the liver, and this is probably a high estimate. Eating more carbs can’t jam more glycogen into muscles once they’ve reached capacity, the resulting glucose in the blood will only get turned into fat. You can use nearly all the liver glycogen but muscle glycogen can only be used by the specific muscles that store it so your leg muscles will only utilize the glycogen that they store, or the liver glycogen. So, let’s say out of the total 2,000 you could store, your legs and brain can only use about 1,700 calories worth. (An extremely well-trained athlete, doing very carefully timed carb loading and training might actually be able to store and use up to 3,000 calories, but I'm guessing this will not be the average reader.)

The number generally referenced for calories burned in a marathon is about 100 calories per mile so you’re going to need around 2,600 calories. If you aren’t adapted to burning fat (which you won’t be if you eat those plates of spaghetti to carb load and down the energy drinks and gels during an event) you are going to have to make up the difference somewhere. So you need to have the gels, drinks, and beans to make up the difference. Unfortunately, if you try to consume those too fast you have a problem with the concentration of sugar (osmolarity) is the stomach. You can only tolerate so much or you are going to get sick. From what I’ve read, you can only absorb about 100 calories every 45 minutes to an hour during a marathon. It doesn't do much good for the calorie deficit I refer to above, to consume carbs at the very end of the marathon, and your ability to digest decreases as the marathon goes on, so with a median marathon time of around 4:45, you are only going to be able to consume about 400 to 500 calories. (If you run faster than that, you're going to need more calories in less time and can absorb even fewer calorie during the event.

That means you are only going to have about 2,200 to 2,300 calories at the very most to play with and you are going to need about 2,600. This is when you hit the wall — you simply run out of accessible energy. If you could get to the extreme 3,000 calories available to an elite athlete (with very well-timed carb consumption and training) you should be able to do a marathon without hitting the wall, and not having to cram down fast carbs via gels, energy drinks, etc. But for most of us, that's not going to work. We simply can't get enough fuel. A good article on this subject is here.

If you look at endurance cycling, it's even worse. Most typically burn about 800 calories per hour cycling with a 15 MPH average speed. So for a century ride (100 miles) that's about 5,300 calories in about 6 to 7 hours. Hence cyclists tend to load up on bananas, granola, peanut butter and the like at SAG stops.

But there is a better (at least different) way. Carbs and fat are the two primary energy sources our bodies can use. Unfortunately, if we regularly consume a high level of carbohydrates (say 150 to 200 gms/day or more) the insulin that must be secreted to process those carbohydrates, also locks up fat stores. For many of us, those fat stores are not easily accessible until our bodies are forced to learn to use fat. This is a process that takes a week or more while minimizing carbohydrate consumption. At most a typical person can store, and access for running, about 1700 calories, as mentioned above. But even a very lean (10% body fat) male at 175 lbs would have over 60,000 calories stored as fat. A more typical, healthy weight individual would have more like 100,000 calories or more of stored fat. If you consistently consume high levels of carbohydrate and continue to consume those throughout an event, you can't access that energy stored in fat because the insulin in the bloodstream blocks its release. I compare this to a tanker truck hauling gasoline that runs out of fuel (diesel) on the highway. It's loaded with fuel that it can't use.

Contrast this to someone who is adapted to burning fat and ketones. (This is what happens if you limit carbohydrate consumption to less than 50 - 75 gms/day for about a month and is called a ketogenic diet.) Even an average, lean individual now has access to nearly 100,000 calories. They should be able to complete a marathon without taking in any additional calories. Think about it, no carefully timed carb loading, no trying to consume enough energy sources during an event without getting sick or hitting the wall.

This is true if the exercise remains below the anaerobic threshold since both fat or glycogen/glucose can be burned aerobically. If the exercise is above the anaerobic threshold however, glucose or glycogen are necessary. (This might be the case with a sprinter or weight lifter.) Most endurance sports participants would remain below the anaerobic threshold for most of the time so this wouldn’t be an issue with endurance running, cycling, or triathlons.

If you really want to geek out on this, here’s an article about how Dr. Peter Attia experimented on himself with exercise of various levels of exertion both in and out of ketosis. Some other good information on the topic of nutrition and endurance sports performance are in this paper and this video by Dr. Jeff Volek.

Finally, I recommend this book, also by Dr. Volek and Dr. Phinney on this topic and the success they've had in transitioning endurance athletes to a ketogenic diet approach. (Note that I receive a small fee for customers who purchase on Amazon through this link but it doesn't affect your cost at all.)

I've experienced some of these same benefits. For example, I can spontaneously go a day or more without eating and not feeling weakness or lack of energy. In fact, when fasting, I experience a great deal of energy. About a year after I started this approach to nutrition, I decided to start cycling again after a multi-year hiatus and ended up doing a century ride that year. I ate a high fat bacon, eggs, sausage breakfast (no toast) and then did the ride in about 6-1/2 hours, and consumed no real carbs along the way. I only drank sugar free energy drinks to maintain electrolytes and had a couple handfuls of macadamia nuts but never felt that I really needed them, and never felt any lack of energy. Similarly, I did a 1/2 marathon one afternoon (walking at a fairly fast pace -- a 2:41 time) completely fasted. I had no breakfast. I consumed nothing before, during, or after the event. Again, I never felt any lack of energy. I plan to do a century ride in the next year or so completely fasted. I'm not expecting to have any difficulty doing so, and know of others who do this routinely.

So while it's possible to get enough energy for endurance sports through carbohydrates and carb loading. I think there's a better option and I for one plan to continue to take advantage of it.

There is tension between those who are discovering a simpler, more effective approach to health, and those of the "conventional" scientific community, and I find myself strangely torn between the two camps. There are those who question big business and see something of a conspiracy to make us all sick, and there are those who defend business and insist that there is no science behind these conspiracy claims and that those making them are either simply misled, or crazy.

Having a degree in physics, and having spent most of my career involved in technology, I had always been quite skeptical toward those who I felt were ignoring science and trashing technology. With the advent of the internet, information is much more available. This means that I've been able to learn and study a broader range of topics (and thus my immersion in nutrition and health as well as this blog). It also means that those with fringe ideas now have much more of a voice. There's much more information -- both true and false out there.

There is truth spoken by those on both sides, but the passion for each side leads to overstatement and then confusion by those who are just trying to learn the right thing to do.

I'm going to examine this tension by first looking at GMOs (Genetically Modified Organisms). I may have a second part post looking at things like vaccinations, another place where this controversy seems to boil.

GMOs aren't necessarily bad

Much of our food today, whether we realize it or not, comes from organisms whose genes have been modified by man. Loosely called "gene splicing," this technology can take genes from one organism and splice them into the DNA of another organism. The intent being to endow an organism with a unique, useful property. This technology has created such bizarre creatures as the "GloFish" and a "see-through frog."

On the food front, no doubt the most commercially successful products are "Roundup Ready" crops. (See a small sampling of the different viewpoints to that part of the debate here, here, and here.) These genetically modified plants were designed to be highly resistant to glyphosate, the active herbicide found in Monsatno's "Roundup" product. Roundup would normally damage ordinary crops but doesn't affect these engineered plants. In this way, farmers can use Roundup and get rid of weeds without worrying about harming their cash crop.

Genetically modifying organisms sounds somewhat futuristic to some and can be quite scary. After all, could they be letting some dangerous, mutant life out there that could take over the planet?

One thing we have to realize, is that we've been genetically modifying crops since agriculture first started. The simple act of choosing seeds from plants based on the favorable characteristics of those plants is a crude form of genetic modification. (Natural selection itself is a form of genetic modification but I suppose we would say that it's, . . . well, . . . natural.)

As these techniques got better, agriculture was able to speed up the process and make it more precise and targeted, with techniques such as hybridization, cloning, and grafting. Ultimately culminating in the genetic modification we think of today (gene splicing.) These differ not in what they produce, but the rate at which changes can be made. Changes brought on by the earliest plant breeding happened almost randomly and took many generations to make substantive changes. Today, man can add traits to plants from wholly other life forms in one generation.

i don't think there's likely a huge conspiracy by big business

While I think some of the practices by the big businesses involved can be a bit shady (for example the controversy around the patenting of these GMOs and the alleged harassment of farmers whose own crops may get tainted with the genes from those GMOs), they are doing exactly what they're charged to do by the their shareholders -- maximize profits.

Their goals are to provide new products that increase harvests and ultimately the popularity of, and profit from their products. Their goals are not to make us sick or to produce products that will intentionally harm us. Indeed, it's true that modern agriculture has made it possible to feed more people than ever before. (Whether that food is truly healthy is a different question altogether.)

I'm still avoiding GMOs

With all that said, when I have a choice I choose organic where I believe it makes a difference, in order to avoid GMOs, pesticides, etc. Why do I say that, when I just argued that the only real difference between things like basic agriculture and GMOs is speed?

The rate of change of the genes of a food does matter. The important point to understand, in my view, is that the changes that were made, were intended to improve the profitability of these crops. The changes were not made to enhance the health of those consuming them. Obviously, if the taste or process-ability of the crops changed in the process, that would be an issue and would have to be considered by the businesses involved. The statement I hear from supporters of these products is that there have been no differences in the foods detected. Not detecting a difference doesn't mean there isn't one. For GMOs, I don't really believe there's been enough time to fully understand all the potential unintended effects on those who consume them. We are just now understanding the effects on health of foods from highly evolved grains -- not even GMO grains. These grains contain proteins (e.g., Glia-Alpha 9) not even present in older breeds of grain.

Studies cannot disprove a problem. Yes, with a large preponderance of good studies over many many years, we can gain confidence in a thing's safety. It is very unlikely that we're there yet with GMOs, particularly since those developing these products are only focused on improving yields. So, since I can afford it, I'll generally choose something else.

... all "GMOs"

I believe that changing the nature of food through artificial means, even just the breeding that came with the development of agriculture, does not give humans enough time to adapt. This has brought serious negative health ramifications.

New strains of wheat with unique proteins for example, or most any modern fruit, with highly enhanced sweetness. We are learning that these can lead to serious health problems.

You could almost say that my whole approach to nutrition these days is to avoid all GMOs. And by all, I mean those that man has modified by any means, even through basic agriculture. I do recognize that it's almost impossible today, but by sticking to the concept of "eating real food," I think I can come pretty close. I also have found that my pallet has become more sensitive to enjoying the taste of real food.

I don't want the government to tell me what I should or shouldn't eat

On the other side of this, I don't want the government to ban GMOs or otherwise tell me what I can and can't eat. The government already tells me I can't consume raw dairy, but if I choose to take whatever risk (or seek whatever benefit) that brings, I should have the ability to do so. I should have the freedom to choose what I want to consume, even if someone thinks it might hurt me. The advice from government (such as the food pyramid) has proven to be so misguided anyway, that the things they would say I can and can't eat would be highly questionable to say the least.

Labeling

Being able to make an informed choice is the only place I would be OK with government involvement. It's not very easy to tell GMO from non-GMO on the shelf. So insisting that suppliers inform the consumer is not a bad thing. Then again, the marketplace might be a better way to ensure this. The Chipotle restaurant chain is a good example. They aren't perfect, but their favoring better food quality is driving commercial success. Let existing truth in advertising laws deal with those who would mislead the consumer.

I don't suggest that people count calories or even track with great accuracy the macronutrients they eat. I believe if you just focus on avoiding the macronutrients that can be a problem for most of us (carbs) and eating good quality, real foods, then the rest will take care of itself. That has worked pretty well for me in the last several years. I don't count calories, at all. I just watch what I eat in terms of avoiding carbohydrates and focusing on real food.

Even with that, when I was learning to eat better three years ago, and when I've talked with others about how they eat and can improve, I see that tracking what you eat with a food journal can be very helpful. That snapshot of where you are at a point in time can give insight as to how you are doing, allows you to focus on the right balance of food, and can help you learn if changes are needed.

I thought it would be interesting to take a look at what I typically eat today and compare it to how I used to eat years ago. In other words, my "before" and "after" snapshots, using food journals.

I didn't actually capture a food journal for before, but it is pretty easy to think about a typical, representative day, and recreate a food journal that's probably pretty accurate. While I knew this exercise would be pretty educational to demonstrate the use of a food journal for the purpose of this blog post, I was quite surprised by the insight it gave to me about how and why this diet works.

BEFORE

Here is my diary from a typical day of food a few years ago was when I was trying (not always successfully) to follow the "conventional wisdom" guidelines for diet.

During my typical day years ago I estimate I would consume a total of about 2,900 calories, 43% from carbs, 44% from fat, and 13% from protein. The protein intake would have been around 96 grams.

I was also consuming roughly the recommended, or slightly higher, calorie intake for someone my size and activity level. I was consuming around 2,900 calories per day with the recommendation being around 2,700 - 2,900 calories per day. I also remember that I often felt hungry and that I had to eat something every few hours or suffer shakes, headaches, etc, despite my eating on the high side of the recommended range of calories.

The protein intake was probably right where it should have been based on my current understanding, while the carbohydrate intake is much higher and fat lower than what I understand today to be the best approach for me. The carb intake is on the low end of the conventional recommendation (about 43% versus the recommended 45-65%) and fat intake is above the conventional recommendation (about 44% versus the recommended 20-35%.)

AFTER

My diary from a typical day of food today is a bit different, to say the least.

During my typical day today I estimate I consume a total of 2,200 calories with a minimum recommendation for someone my size and activity level being around 2,600. Keep in mind that I do not feel like I'm starving and am almost never hungry despite the lower calorie intake, and can go for hours, or even a day, without feeling like I need to eat or risk having the shakes or headaches.

My protein consumption works out to be exactly the same at 96 grams! (This was not a setup, it actually came out exactly the same.) If you ever hear of this being a "high protein" diet or the dangers of a "high protein" diet, realize that this is not, and that is not what I recommend.

I now consume around 76% of my calories from fat (well above "conventional wisdom" of course) and my carbohydrate intake is around 7% (well below "conventional wisdom".)

WHAT I'VE LEARNED

This was a very interesting exercise for me and I've learned the following from it:

I ate more calories before, and too many for my size and activity level, so I was having issues controlling my weight.

I ate a little less fat in terms of total grams before as I do now (141 grams vs. 187 grams) but not nearly as much difference as I would have thought.

I ate many more calories before, and most of the additional calories came from carbohydrate.

I ate more calories before, BECAUSE I was eating more carbohydrates and had poor control of glucose/insulin swings and the resulting hunger. This also lead to most of the other health issues I was having.

I may be eating too few calories today, so it might not hurt to consciously increase consumption a bit, but I'll look to add a little more healthy fat instead of carbohydrate. I'm pretty convinced that these added calories won't lead to increased weight but probably increased energy. When I had done this previously while I was adapting to this way of eating, I observed that when I increased consumption of fat, my weight decreased even faster.

Although not obvious from the food diaries, I eat much better quality food, and much less processed food today.

I don't believe that anyone should constantly calculate these detailed numbers about their food, or constantly count calories, fat, carbs, or anything else. But occasionally tracking exactly what we're eating can lead to discovery and ensure that we're on the right track.

At a recent morning presentation on the Primal Blueprint, where I decided to bring some primal-acceptable foods for a snack, I decided to whip up a breakfast casserole with what I had on hand.

I did some online searching and found some basic recipes so I had a target for time, temperature, etc. I also had this list of ingredients available to work with;

1-1/2 dozen eggs

Cheddar cheese

Swiss cheese

Baked ham (~1 pound)

Fresh broccoli

Chopped bacon

Chopped onion

Grass fed butter

I don't actually remember the time and temperature but it took quite a bit longer than I thought but turned out quite good, and it's a good, balance dish from a nutrition standpoint.

A good balance of fat, protein, and some carbohydrate.

Quality, as usual, is a little more difficult to estimate since the sources aren't always known. I did know I had good quality eggs from pastured chickens at a local farm. The broccoli was organic so the quality there is good. The ham, cheese and bacon are just what I could pick up at the store so I suspect the quality there is not quite as good.

Finally, the micro-nutrition in this dish is probably pretty good as well. With eggs from pastured chickens and the organic broccoli, there are some good micronutrients. I think a dish with more vegetables might be a bit better from a micronutrient standpoint but I think this dish isn't bad.

It's very difficult to know what the right things are to eat. It's not any easier when all around us are advertisements, slogans, and claims on and about packaged foods. Everywhere you look these days among packaged food -- particularly high-carbohydrate packaged food such as cereal, snack bars and the like -- you see protein being advertised as the next great food benefit. What's with this new trend? Is this an earnest effort by these food companies to improve our nutrition?

I don't want to claim that these companies are out to harm us, they're not, but their objectives are exactly what they are required to do to benefit their shareholders. They're out to sell more product. This is not necessarily the same as your objective to eat healthier food.

I think these big food companies are seeing a trend toward paleo, primal, low carb diets and they want to jump on the bandwagon. But they've got a problem. If they were really to embrace this approach, they would develop food that was low in carbohydrate and not lower in fat, but not necessarily higher in protein. If they did that, they'd do two things which aren't in line with their objective to sell more product.

For one, they would scare a large part of their customer base away. That base is made up of average Americans who are convinced, from years of the low fat mantra, that fat is to be avoided at all cost. They avoid any mention about reduced carbohydrates, whether or not their new products have reduced carbohydrates or not. If they mentioned reduced carbohydrate, they fear they would sound like they were suggesting "healthy whole grains" should be avoided. The only safe thing they can say is that they have more protein.

Another likely reason is fear of stirring the wrath of experts in conventional nutrition who would disparage food that is higher in fat or lower in healthy whole grains.

To those who are trying to understand what to eat and what's good for them, particularly those who are trying to follow a low carbohydrate approach, be cautious about buying into the message from these processed food manufacturers. High protein is not necessarily the way to go. You probably are getting enough protein and having more is not going to help you reach your goals.

The list of new Protein-enhanced processed foods I found on a walk through the grocery store;

Special K Protein Cereal (One listing 10g of protein the other with 14g including milk. Other than that I see no difference -- could this be an experiment on their part?)

Cheerios Cinnamon Almond Protein Cereal

Cheerios Oats and Honey Protein Cereal

It's interesting that these protein-enhanced packaged foods are almost all foods that are normally high in carbohydrate. (Cereal, snack bars, etc.) There's also no mention of them having lower carbohydrate since I suspect they don't.

I usually don't end up getting as many vegetables as I would like, so at least once a week I will usually go get a big salad for lunch. In this case I went to Newk's, a restaurant located a short walk from where I work. The "Ultimate" salad is what I usually get, and it's a pretty healthy and appetizing choice.

Newk's ultimate salad is basically a chef's salad including leaf lettuce, cucumbers, tomatoes as well as cheese, grilled chicken, ham, turkey, and bacon. I get it without their honey mustard dressing and instead use the olive oil and vinegar they have available. In this way I avoid the sugar and bad fats that are likely in the pre-made dressing and probably get something more healthy. (I say probably because so many olive oils are cut with unhealthy oils it's hard to tell. I figure I am more likely to get a healthier oil if it at least says olive oil, but no guarantees.)

The macro nutrient content in a salad like this is pretty good. A good balance of fat and protein and low level of carbohydrates. (Note that I eat this without the croutons.) The only thing I would change is the grape tomatoes which have a higher sugar content than regular tomatoes but there's not that much to worry about.

The quality of this meal is a little more in doubt. I have no idea the source of the meats or cheeses. The saving grace on the meat in this meal is that most of the proteins are lean (chicken breast and turkey breast.) The good nutrients in properly raised meat, or the bad nutrients in improperly raised meat, is stored primarily in the fat. This means that when the quality of the source is questionable, a leaner cut is better. Not much choice as far as the cheese, so you're stuck with the quality that you get.

On the micronutrient scale, I would rate this meal reasonably high. With the raw vegetables and possibly the olive oil, (assuming it's reasonably high quality virgin olive oil) there are plenty of vitamins and minerals. There could be a wider variety of vegetables to make it even better, but this isn't bad.

Overall a good lunch and a good part of a healthy, low carbohydrate diet.

Since the time I adopted a low carbohydrate approach, I've heard a frequent concern of people that they don't want to give up their fiber. This sentiment is further heightened by the frequent admonition by "conventional wisdom" that you need "healthy whole grains" and that they are an excellent source of fiber. That doesn't really seem to add up in my mind when you think of things like so many of the vegetables and other foods that are perfectly suitable in a low carbohydrate approach.

After hearing this again several times over the last week as part of a couple presentations I've given on the Primal Blueprint, I decided I would see if I could do a real comparison of what you give up when you give up "healthy whole grains" and replace that with other real foods that don't contain a lot of digestible carbohydrates.

[Note that when I talk about carbohydrates, generally I am talking about those carbohydrates that don't include fiber. When you look at the total carbohydrates on a nutrition label, it includes fiber which is pretty much indigestible and doesn't have the same impact on insulin. So, when I mention the amount of carbohydrates, I mean the total minus the fiber. In other words, I don't count the fiber.)

To look into this, I first chose a slice of whole wheat bread and a single serving of oatmeal to see how much fiber they really contain. A slice of whole wheat bread only contains about 2.8 gms. of fiber and a serving of oatmeal contains about 4 gms. of fiber.

Interested in seeing if we can really adequately replace the fiber in "healthy whole grains" with the fiber in better food choices, I then looked up a few non-high-carbohydrate foods, to see what fiber content they have. I chose 1/4 avocado, 1 serving of almonds, 1 serving of macadamia nuts, 1 serving of celery, 1 serving of carrots, and 1 serving of broccoli. It turns out that there's not much agreement when searching on the web for a standard serving size so I just did the best I could. For example there really wasn't anything for a serving size of avocado but I picked 1/4, even though I generally eat 1/2 at a time when I'm having some, but 1/4 still has plenty of fiber. For a serving of nuts, I used 1 oz. (28 gms.) which seems to be pretty consistent and is only about a small handful, and is probably less than I might typically consume in a day.

From the numbers I found (and you're welcome to look up numbers for what you think is a serving size) the amount of fiber in these foods can easily replace the fiber in the so called "healthy whole grains." I conclude that there really is no reason to eat grains to get the fiber you need.

I graphed the numbers I found for fiber below. I think it makes it clear that there are obviously variations in the amount of fiber in different foods, but these low carb foods are still a substantial source of fiber in the diet. Very much on par with the whole grain foods.

I also looked at what the carbohydrate content (not including fiber) is of these foods. I've graphed those numbers below as well. Note that the highest of the "low carb" foods doesn't even have half the net carbs of the whole wheat bread.

That made me think that I could calculate a "fiber density index" of sorts by dividing the fiber content by the net carbohydrate content. In other words, this would be a measure of how much good fiber you get from a serving of food as compared to how much of the carbohydrate that you don't want. I graphed such a calculation for that selection of foods as well. Interestingly it shows how much more effective these low carb foods I selected are at providing good fiber without adding all those carbs, versus the whole grain foods. This shows as a proportion of total carbs, whole grains are really not very good at providing fiber without the penalty of taking in those digestible carbs.

So the next time you think you need to get more fiber, you don't need to resort to eating whole grains that are going to generate insulin spikes that are probably not good for you. Instead try an avocado, some nuts, or some non-starchy vegetables. I think that's a much better choice.

I wrote this article because someone had asked me what I thought of this product. As you'll read in the article, I don't think much of this product from my own nutritional perspective. What blows me away is that this is by far the most popular post on my site! I frankly can't figure out why. I'd love to get feedback on what you, my readers, are looking for when you've visited this page. Please leave comments below, or use my feedback page for private feedback, and help me figure out why this page is so popular!

Recently, I was asked what I thought about Brummel & Brown butter made with yogurt. I had never heard of it so I checked it out online. What I found was that it is based on some key things about how we're mislead about what's healthy, and despite the Brummel & Brown web site name, I don't believe it is making our lives better.

Brummel & Brown yogurt spread is a butter-like spread that says it's a "Spread made with nonfat Yogurt." That's a clue right there. Nonfat is not something that you want. (Note the key word there; "spread." There's no mention of butter -- they wouldn't dare. There's no butter to be found.) The web site lists the nutrition label with the ingredients. Here's the link to the web page. (You need to click the link for "Nutrition Facts/Ingredients below the picture of the spread.)

Gelatin: Generally OK, but real butter doesn't need it, but I guess they do to hold together the water and vegetable oil.

Nonfat Yogurt: There's the star ingredient. Yogurt's generally good but of course the fear of fat means it's nonfat. This is not a good choice. Real butter is a much better choice.

Soy Lecithin: While soy is generally to be avoided, soy lecithin doesn't contain enough of the anti nutrients to affect most people, but again, real butter doesn't need it.

Then there's a number of other additives and artificial ingredients that real butter doesn't need.

I would say this for Brummel & Brown Spread with Yogurt, as well as other vegetable oil-based spreads. They are definitely to be avoided. Use real butter, preferably from grass fed dairy. Kerry Gold is a good reliable brand you can now find at many stores. If you haven't tasted real Irish butter like Kerry Gold, you haven't tasted real butter. I feel it's a much better option that this artificial stuff that's not really good for your health.

As I try to eat right, one of the questions that comes up; "Shouldn't I always buy and eat organic?" Beyond my admonition to try not to be so perfect that you stress out or abandon the good in search of the perfect, there are still good reasons to sometimes buy organic, and sometimes just not worry about it.

There are a number of advantages touted for organic products. Some of these I very much understand and take advantage of, some of them are being questioned in recent studies, and some of them I don't much worry about.

Organic Plants Have More Nutrients

I think the jury's out on this one. In principle, growing food organically means the farm can't depend on chemicals and things to keep the plant healthy. This would imply that the nutrients to feed the plants would have to come from the soil, implying that the soil may need to be more rich than the soil where non-organic plants are grown. Studies on the subject seem to be split and probably depend mostly on who sponsored them.

Bottom line: I think this is probably true but probably not enough to go too far out of my way to buy organic.

Organic plants and animalsexpose you to fewer chemicals

This is my primary reason to buy organic when I do. I use a relatively simple rule of thumb. If it is a food you are consuming the outside parts of, the parts that are exposed to most of the chemicals in question, then I try to buy organic. If not, then I don't feel I have to go out of my way to buy organic. For example, avocados -- I don't need to buy organic since I don't eat the skin. Another example, leaf lettuce -- I try to buy organic since the leaves are exposed to all the potentially toxic chemicals.

A good website for ideas on what you should and should not buy organic for this reason is ewg.org On the site they highlight their "Dirty Dozen" (the foods from which you will have the most exposure to chemicals and the ones you should buy organic) and their "Clean 15" (the foods that have the least exposure and the ones you probably don't have to worry about getting organic.)

Organic processed food

Using organic doesn't help you if it's highly processed food in the first place. You should avoid highly processed food and eat "real" food. Ignore the label "organic" on highly processed foods and avoid those foods altogether.

Not GMO

This is a tough one. All else being equal, I would probably choose non-GMO. I don't believe that GMO is inherently bad for us, just because it's GMO. I'm not "scared" of it just because it's genetically modified. We've been genetically modifying foods for 1,000s of years. We used to (and still do) genetically modify crops by selectively breeding them to get the characteristics we want. GMO isn't much different -- just a whole lot faster. The biggest problem with that is that the objective of the modifications is all about productivity, resistance to spoilage, palatability, etc. Health doesn't likely play a big role. That means these crops are bed to be ultra sweet, palatable, etc. and are likely less heathy for us. But that's already happened, long before GMO was an acronym. Read the book Wheat Belly to see the effect this had on the modern wheat we eat and what it does to us. (You can buy at at the sponsored link to the right and help to support this site.)

My biggest problem with GMOs is the way the big companies such as Monsanto are treating local farmers, suing them because their crops end up containing genetic material that is patented (something I think is totally crazy to begin with.) The contamination of those crops is likely due to natural processes like wind driving pollination from neighboring GMO crops.

I've certainly not covered every possible reason to buy organic food, but if all else is equal, I would definitely choose organic. If it's much more expensive or hard to find, and it's not one that I think would have a strong effect on health, I don't go too far out of my way.

I know it can be difficult to make changes in your lifestyle in order to improve your health. These typically involve diet changes because your doctor tells you to lose weight and/or improve your cholesterol or fasting blood sugar. I know because I've been there and felt the frustration. In fact, I had gotten to the point where I felt it was impossible, I didn't have the willpower and couldn't figure out how to lose the weight or improve my cholesterol or blood sugar.

In retrospect, now that I have learned and practice a better lifestyle approach to health, I can see that there are probably three scenarios why people might be having trouble. For the most part, in these scenarios, any failures in seeing success are probably not your fault. Here are the three scenarios as I see them.

You are following the recommended approach to the letter

In this case you've listened to your doctor tell you that your cholesterol and/or blood pressure and/or fasting blood sugar tests are getting too high. You're told that you may need to start medication soon but you can give lifestyle changes a try. You're told you should lose some weight, you should follow a healthy diet (and a specific diet may or may not be suggested,) and you need to exercise more. All of the suggestions, at least in my experience, are pretty vague, and may leave you without much to go on for how to proceed. But, you take on the challenge, thinking you really don't want to start new medications and be stuck on them for the rest of your life, and you rigorously follow the "My Plate" guidelines (or DASH diet, or whatever.) You might start walking regularly (great!) or join a Gym and "work your butt off" four or five times a week. The result: probably little or no positive change. You've likely lost little to no weight or you may have even gained weight, you don't really feel any more energetic, and you may or may not have seen any change in your lab tests. Or you've seen positive changes, but then over time your health results degrade once again, even though you rigorously follow the recommended action plan.

Your doctor may say that you need to try harder, and/or give up and prescribe medication to improve your "numbers." This implies that you just didn't try hard enough and with just a little more willpower, you could make progress. But you know you've done what you've been told, to the letter, and you still aren't seeing the results you would like. You assume this is due to the genes you've inherited or that it's just a part of the process of growing older. The problem is not you, it’s not your genes. Your genes want you to be healthy and fit. The problem is the advice you’ve been given.

You're trying to follow the recommended approach,but have trouble sticking to it

In this case, you think you are starting off well. You're eating what's been recommended, you're even exercising. But after that workout at the gym, you stop in for some ice cream. (Hey, you've earned it, and after all, you chose the low fat frozen yogurt!). You end up hitting the fridge for a midnight snack, or giving in to a rich desert at a business dinner. I've been there too! The thing is, after I would give in to that temptation, I would feel guilty and maybe even tell myself I wouldn't do that next time. Of course, I would indeed give in to the temptation the next time. After going through that cycle, it only leads to frustration and guilt, and an even lower level of willpower.

Again, I think this is not your fault! The current conventional wisdom regarding a healthy diet requires a huge amount of willpower. Some may be able to do it, but for the people who most need the help, this diet causes the cravings, and makes it virtually impossible to succeed. Just look at the levels of obesity, type 2 diabetes. That conventional wisdom doesn't seem to be helping, and I don't believe that most of these people are lazy sloths that have no willpower and ignore what the health care system is telling them.

You don't want to try to change because it looks too darn hard, and besides, you've probably inherited it

OK, so maybe this one is partly your fault. You need to decide to make a change if change is going to happen. But you may have been misled. 1. You've been misled about how hard it is -- you've seen "Biggest Loser" or imagine people constantly working out at a gym and the hell those people go through to lose weight ... or 2. This problem runs in your family so why should you try to fight it since it would be a losing battle.

While I know it can be hard to make changes in your life, following a good plan of eating real food, and strictly limiting consumption of grains, sugar, and sugary and starchy fruits and vegetables, if you give it a real try, can make it much easier once you've made the adjustment.

Except for maybe a very limited few, I also don't believe that it is pre-ordained in your genes that you should become obese and sick, even if that's the fate of your parents or siblings. I truly believe that for most everyone, your genes want you to be healthy, and you just have to give them the right raw materials and environmental signals to work with. If this wasn't true, I don't think we'd be here as a species, we would have already died out.

So it's (probably) not your fault! There is a way to turn things around with your life and health. You just need to find and stick with what works, and I'd strongly suggest that the advice on these pages give you a real advantage in making that work.

Change can be daunting and I know it does take some willpower to get started. So, find someone who has done it and succeeded and find out how they've done it, or find a coach you can trust. The Primal Blueprint Certified Expert program is now available to start providing these experts. (If you're in the central Tennessee area, I may be able to help.) Use the information on these pages, or the references I've suggested. Just don't give up. The conventional wisdom has conspired to make it seem like it's your fault, but there is a way to change things to your advantage.

One of the common foods that people look to replace on a low carb diet is pasta. One of the great substitutions is spaghetti squash. While spaghetti squash does form long strings, somewhat like spaghetti, I don't really think of it as being the same a spaghetti at all, and doesn't really taste the same to me. It is however a great part of a tasty meal.

This dish is pretty basic with meatballs (made with ground beef from grass fed beef of course), a simple homemade marinara sauce (to avoid store-bought sauce with added sugar,) and the spaghetti squash. (Hint: When I make the pasta sauce, I use just a pinch of baking soda. This cuts some of the acid from the tomatoes, which is something that the sugar normally in the store-bought sauce would do. Don't use much though since otherwise it will make the sauce taste pretty flat.)

This recipe cleverly uses the halves of the spaghetti squash shells as the bowl. We ended up with 4 individual meals from one squash and a pound of ground beef.

From a macronutrient perspective this is a good dish. There are some carbs coming from the spaghetti squash itself, something like 10 gms. of which more than 2 gms. are fiber. Otherwise there's plenty of fat and enough protein from the mozzarella cheese and meatballs.

The quality of this dish is good as well. The grass fed beef is great. The only hesitation I have is the mozzarella cheese since I don't know the source of the milk for the cheese I used. (Could be grass fed, but more likely from a factory farm and fed plenty of grains.) But it was a more natural mozzarella that I used -- only a couple ingredients on the label and not a highly processed/preserved shredded mozzarella. Also, using that kind of mozzarella melts and tastes much better.

Nothing exciting on the micronutrient scale but certainly nothing terrible since I tried to use good ingredients from good sources.

My last post was about how easy it is to become confused about nutrition. In that post, I cautioned that we have to careful about believing headlines, and also to be careful when an article says something is associated with something else. I thought I would delve into that content a bit deeper. See the headline above (the title of this post.) Certainly sounds crazy and hard to believe, but follow along and see how reporting on a study, not unlike the typical reporting on the latest nutrition-related study, can be misleading.

Margarine Linked to Divorce, recent study reveals

Researchers at Big University of Maine (BUM) were out to discover the reason for the 18% decline in divorce rate that has occurred over the past 10 years and made a startling discovery. Trying to find any cause for this decline, they turned to dietary habits and examined USDA data on per capita margarine consumption in the United States. What they found was a strong association between the use of margarine and the divorce rate in Maine. The decline in margarine consumption they found correlated very strongly with the decline in divorce.

When asked about their groundbreaking research the authors of the study commented; "This study appears indicate that if we limit our consumption of margarine it will lead to better marital relationships and thus a reduction in the divorce rate." If these findings prove to be correct, it indeed seems possible to reduce divorce. Speculating on the reason for this relationship the authors say they believe it has something to do with the reduction in fat consumption that leads to better overall health and a corresponding improvement in marital relations. "We think this is a big step in reducing the divorce rate. If people will limit their fat intake, we can see divorce rates continue to decline. There's no reason this couldn't be applied across the whole country."

This is a real association using actual data. I got it from a great web site titled "Spurious Correlations." The creator of the site, Tyler Vigen, emphasizes that these correlations are not meant to imply causation. The difference is key to understanding reporting on any research, but particularly nutrition research.

If there is a correlation between two things, it means that as one changes, the other changes. In other words, if A and B are correlated, then as A goes up, B tends to go up, or as A goes up, B tends to go down. (One of these is a positive correlation, the other is a negative correlation.) Notice that I didn't say that A causes B. Correlation does not mean that something causes something else, it just means that when one changes, the other one seems to change. They are probably related in some way, but you cannot conclude that one of them causes the other.

So for the example with divorce rates and consumption of margarine, you can see by the graph that they really are correlated. They are strongly correlated. Over the 10 years of data provided, as one changes the other changes in step. But you should never conclude from this that margarine consumption causes divorce, or even that divorce causes margarine consumption. So when you read a story or hear about something being correlated with (or associated with) something else, DO NOT THINK THAT ONE CAUSES THE OTHER.

So why would margarine consumption be correlated to divorce rates? Maybe both of them are related to something else. One possibility might be that over those 10 years the income increased or declined influencing both the chances of divorce as well as the food choices that people buy.

There is value to studies that look at correlation using existing data. They are great clues to what may be going on. For example, let's think about the relationship between cholesterol and heart disease. Early in the study of heart disease it was observed in people with atherosclerosis (where plaque builds up in people's arteries) that where this exists, there is a lot of cholesterol there. So that's a great observation that there is something going on between the disease and cholesterol. That does not mean that cholesterol causes atherosclerosis. Maybe it means that atherosclerosis causes the cholesterol to be there!

An excellent analogy for this that I've heard is that if we wanted to prevent fires we could go to a bunch of fires and make observations to see what else is there and try to figure out how to prevent them. What we likely would find is that there is a very strong correlation between house fires and the existence of fire trucks. We could conclude that fire trucks cause fires. A better conclusion though would be that fires bring fire trucks. The same is probably more true about Cholesterol.

Be very wary when you hear about studies citing one thing is correlated with (or associated with) another. Don't believe it when it is then claimed that to prevent some disease, that the correlation means you should reduce (or increase) the consumption of something else.

It’s really no wonder all of us have trouble eating a healthy diet. With the wealth of information that is available in today’s connected society, you would think that we have all the information we need to make the right choices, if we choose to eat healthy. The problem is, as easy as it is to publish information to a large audience today, almost any information can get published. That means, if there’s something you want to learn about, you’re likely to find articles arguing both sides of the question.

In addition, web sites, news reports, and articles all want to grab your attention, so they invent headlines to do just that. These headlines though, aren’t necessarily accurate at conveying the truth of the subject. This is particularly true when reporting on the latest health research. As an example look at this list of headlines and comments on nutrition that I pulled from the internet, using just a quick search.

“Counting calories: Get back to weight-loss basics”

“Don’t Count Calories, Count Cups”

“Why You Don't Need To Count Calories Ever Again”

“Why White Rice is Healthier Than Brown Rice”

“Why Brown--But Not White--Rice is One of the World's Healthiest Foods”

“Overall, saturated fats do not harm the blood lipid profile like previously believed.”

“5 Healthy Whole Grains To Add To Your Diet”

“How Grains Are Killing You Slowly”

“The health benefits of agave nectar”

“Agave: Why We Were Wrong”

“Why is salt bad for our health?”

“Shaking up the Salt Myth: The Dangers of Salt Restriction”

While some of these differences represent honest changes in our understanding of what’s healthy, most are due to different slants on the subject, biased research, or sensationalism in headline writing.

So, what’s a person to do?

The first thing, stop believing the headlines! Read beyond the headline to see what evidence is actually being presented and then see if it rings true.

Look at the probable biases of the presenters of the article or the researchers involved. When I read highlighted text in an article that says; “Plain grains -- from brown rice and quinoa to wheat berries –– and whole grain pasta should be a regular feature on your table,” I should take that with a grain of salt (no pun intended) when I see that it is on the web site wholegrainscouncil.org.

When you read in an article about lowering LDL cholesterol saying; “[The study] suggests that lowering LDL-cholesterol levels to very low levels results in a significant reduction in cardiovascular events,” would it surprise you that one of the authors of the study works for Pfizer, the maker of Lipitor and other statins? That doesn’t mean that drug company researchers are automatically biased, but it should make you think twice.

Look for telltale signs in the article that should tell you that the evidence is weaker than the headlines claim. Look for words like “associated with” or “researchers believe.” I’ll get into more about what an association is and why it doesn’t mean what you think in a later article, but for now, beware.

Moreover, find a couple sources that you trust that can do the research for you, and who read the actual research papers to determine how strong the evidence really is. The ones I generally trust, who seem to study the claims, and give honest assessments are;

Test things yourself. If you’re puzzled about the truth of a specific claim, try it yourself. Change that one thing in your diet and lifestyle and see if it works for you.

It’s hard to navigate the flood of too much conflicting information, but with a little critical thinking, seeking trusted advisors or coaches, and seeing what works for you, it can be done successfully.

The conventional wisdom, and the mainstream approach to diet and exercise is that you must balance "calories in" with "calories out." What does that really mean? I'm going to attempt to answer that from my perspective, and talk about why I think it is more or less true, yet misguided advice. While calories in may balance calories out, a low carbohydrate approach can take the natural processes that our bodies use and turn them to our advantage. We can make the process of improving our body composition and improving overall health (usually that also means losing weight) relatively easy and automatic, instead of a tremendous feat of willpower.

The conventional wisdom on diet and exercise can be summed up in the concept that the calories in the food you eat (calories in) is either burned up, or is converted to fat. When you exercise you burn calories (calories out.) Part of the “calories out” is your “basal metabolic rate” which is simply the energy your body needs to stay alive, even if you are doing nothing else. The idea is that this simple equation governs whether we gain or lose weight. If we eat more and don't exercise more, we gain weight. If we eat less or exercise more, we lose weight. When put this simply, it’s essentially true, but there are more things going on and our bodies aren't that simple, and how easy it is to hold that equation in balance can depend a lot on what kind of calories you consume.

If we eat a conventional diet, high in carbohydrates and low in fat, we really can affect our body composition by consciously limiting our intake of calories and constantly exercising to burn calories (think “The Biggest Loser”). If you can do that, you can improve body composition, lose weight, and be fit. The problem is, you will have to really work at it, you’ll need to have strong willpower. (Think “The Biggest Loser” again and all the made-for-TV drama as the contestants struggle to stay on the program, driving themselves or being driven to exhaustion, while basically starving.)

If we try to limit our food intake, we are fighting our own body’s chemistry and will have a real struggle. The primary reason this happens, is that when we consume carbohydrates, they quickly turn to glucose in the blood. (See my post on why LCHF diets work.) As glucose goes up after a meal, it must be removed from the bloodstream since too much is toxic so insulin is secreted. Insulin drives blood glucose back down. Assuming someone on the standard American diet high in carbohydrates, the constant insulin surges keep the body form having access to burning fat so when blood glucose drops, this signals more hunger which must be countered with sheer willpower.

If we try to hold our “calories in” the same and just try to burn more calories (exercise more) we run into another problem. Our bodies know we’ve burned a lot of calories. If we are consuming a high carbohydrate diet, we can’t access our stored body fat because the constant insulin surges cause fat cells to hold on to their fat stores. This leads to fuel not being available, particularly to the brain which triggers an overwhelming drive to find food. Unless we have tremendous willpower, we’re going to eat more and cancel out all that work we did to burn more calories.

The worst case of ramping up exercise and forcing ourselves eat less compounds the problem. And if we're constantly exercising (again, like you see on "The Biggest Loser") you crank up cortisol (the "fight or flight" response) which also triggers the body to hold on stored fat and more hunger.

If we eat a low carbohydrate diet, we still have to eat fewer calories than we burn, more or less, if we want to lose weight. The advantage with this approach is that without the constant insulin surges, our fat cells are more than happy to provide the energy the body needs, and we don’t experience the drive the eat. In fact, if we have some fat to lose, our bodies will actually seek ways to burn more of our fat, giving us a tremendous amount of energy.

So we’re not violating some natural law that calories in equal calories out. We’re not cheating the system. We’re leveraging the body’s natural systems to our advantage. Turning from the need for a an almost superhuman feat of willpower, to an almost effortless, automatic, and quite natural process.